The Application of e-Mental Health in Response to COVID-19: Scoping Review and Bibliometric Analysis

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Abstract

Background

The COVID-19 pandemic and its mitigation measures and impacts, such as shelter-in-place orders, social isolation, restrictions on freedoms, unemployment, financial insecurity, and disrupted routines, have led to declines in mental health worldwide and concomitant escalating demands for mental health services. Under the circumstances, electronic mental health (e-mental health) programs and services have rapidly become the “new normal.”

Objective

The aim of this study was to assess key characteristics and evidence gaps in the e-mental health literature published in relation to the COVID-19 pandemic via a scoping review and bibliometric analysis.

Methods

We conducted a search of four academic databases (ie, MEDLINE, Embase, PsycInfo, and CINAHL) for documents published from December 31, 2019, to March 31, 2021, using keywords for e-mental health and COVID-19. Article information was extracted that was relevant to the review objective, including journal, type of article, keywords, focus, and corresponding author. Information was synthesized by coding these attributes and was then summarized through descriptive statistics and narrative techniques. Article influence was examined from Altmetric and CiteScore data, and a network analysis was conducted on article keywords.

Results

A total of 356 publications were included in the review. Articles on e-mental health quickly thrived early in the pandemic, with most articles being nonempirical, chiefly commentaries or opinions (n=225, 63.2%). Empirical publications emerged later and became more frequent as the pandemic progressed. The United States contributed the most articles (n=160, 44.9%), though a notable number came from middle-income countries (n=59, 16.6%). Articles were spread across 165 journals and had above-average influence (ie, almost half of the articles were in the top 25% of output scores by Altmetric, and the average CiteScore across articles was 4.22). The network analysis of author-supplied keywords identified key topic areas, including specific mental disorders, eHealth modalities, issues and challenges, and populations of interest. These were further explored via full-text analysis. Applications of e-mental health during the pandemic overcame, or were influenced by, system, service, technology, provider, and patient factors.

Conclusions

COVID-19 has accelerated applications of e-mental health. Further research is needed to support the implementation of e-mental health across system and service infrastructures, alongside evidence of the relative effectiveness of e-mental health in comparison to traditional modes of care.

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Most cited references 97

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Clinical Characteristics of Coronavirus Disease 2019 in China

Wei-jie Guan, Zheng-yi Ni, Yu Hu … (2020)

Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)

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PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation

Adrian Aldcroft, Chantelle Garritty, Simon Lewin … (2018)

Scoping reviews, a type of knowledge synthesis, follow a systematic approach to map evidence on a topic and identify main concepts, theories, sources, and knowledge gaps. Although more scoping reviews are being done, their methodological and reporting quality need improvement. This document presents the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist and explanation. The checklist was developed by a 24-member expert panel and 2 research leads following published guidance from the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) Network. The final checklist contains 20 essential reporting items and 2 optional items. The authors provide a rationale and an example of good reporting for each item. The intent of the PRISMA-ScR is to help readers (including researchers, publishers, commissioners, policymakers, health care providers, guideline developers, and patients or consumers) develop a greater understanding of relevant terminology, core concepts, and key items to report for scoping reviews.

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Updated methodological guidance for the conduct of scoping reviews

Micah D.J. Peters, Casey Marnie, Andrea Tricco … (2020)

The objective of this paper is to describe the updated methodological guidance for conducting a JBI scoping review, with a focus on new updates to the approach and development of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (the PRISMA-ScR).

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Author and article information

Contributors

Louise A Ellis:

ORCID: https://orcid.org/0000-0001-6902-4578

Centre for Healthcare Resilience and Implementation ScienceAustralian Institute of Health InnovationMacquarie University75 Talavera RdSydney, NSW 2113Australia61 9850 2484louise.ellis@mq.edu.au

Journal

Journal ID (nlm-ta): JMIR Ment Health

Journal ID (iso-abbrev): JMIR Ment Health

Journal ID (publisher-id): JMH

Title: JMIR Mental Health

Publisher: JMIR Publications (Toronto, Canada )

ISSN (Electronic): 2368-7959

Publication date Collection: December 2021

Publication date (Electronic): 6 December 2021

Publication date PMC-release: 6 December 2021

Volume: 8

Issue: 12

Electronic Location Identifier: e32948

Affiliations

[1 ] Centre for Healthcare Resilience and Implementation Science Australian Institute of Health Innovation Macquarie University Sydney Australia

[2 ] National Health and Medical Research Council Partnership Centre for Health System Sustainability Australian Institute of Health Innovation Macquarie University Sydney Australia

Author notes

Corresponding Author: Louise A Ellis louise.ellis@ 123456mq.edu.au

Author information

Louise A Ellis https://orcid.org/0000-0001-6902-4578

Isabelle Meulenbroeks https://orcid.org/0000-0002-9083-7845

Kate Churruca https://orcid.org/0000-0002-9923-3116

Chiara Pomare https://orcid.org/0000-0002-9118-7207

Sarah Hatem https://orcid.org/0000-0002-3542-6138

Reema Harrison https://orcid.org/0000-0002-8609-9827

Yvonne Zurynski https://orcid.org/0000-0001-7744-8717

Jeffrey Braithwaite https://orcid.org/0000-0003-0296-4957

Article

Publisher ID: v8i12e32948

DOI: 10.2196/32948

PMC ID: 8651237

PubMed ID: 34666306

SO-VID: 3c563f0e-48fc-4cc2-94eb-17ec316e58ef

Copyright © ©Louise A Ellis, Isabelle Meulenbroeks, Kate Churruca, Chiara Pomare, Sarah Hatem, Reema Harrison, Yvonne Zurynski, Jeffrey Braithwaite. Originally published in JMIR Mental Health (https://mental.jmir.org), 06.12.2021.

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Mental Health, is properly cited. The complete bibliographic information, a link to the original publication on https://mental.jmir.org/, as well as this copyright and license information must be included.

History

Date received : 16 August 2021

Date revision requested : 8 September 2021

Date revision received : 28 September 2021

Date accepted : 14 October 2021

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